Provider Demographics
NPI:1013348002
Name:ASC SERVICES OF MICHIGAN LLC
Entity Type:Organization
Organization Name:ASC SERVICES OF MICHIGAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDNARCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-452-7111
Mailing Address - Street 1:33400 6 MILE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3165
Mailing Address - Country:US
Mailing Address - Phone:734-452-7111
Mailing Address - Fax:734-452-7129
Practice Address - Street 1:33400 6 MILE RD STE A
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3143
Practice Address - Country:US
Practice Address - Phone:734-452-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty